Provider Demographics
NPI:1649376302
Name:ANTON, XAVIER (MD)
Entity type:Individual
Prefix:
First Name:XAVIER
Middle Name:
Last Name:ANTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3629 PALMETTO AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6220
Mailing Address - Country:US
Mailing Address - Phone:305-461-3348
Mailing Address - Fax:305-444-5195
Practice Address - Street 1:3629 PALMETTO AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-6220
Practice Address - Country:US
Practice Address - Phone:305-461-3348
Practice Address - Fax:305-444-5195
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50614207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB62444Medicare UPIN